Do Kids With Tourette's Usually Have Other Disorders Too?

Tourette’s syndrome is often diagnosed alongside other “co-morbid” disorders, most often obsessive-compulsive disorder and ADHD. Barbara Coffey, MD, the chairman of the Department of Psychiatry and Behavioral Sciences at the University of Miami Miller School of Medicine, talks about how treating these other disorders effectively can sometimes have a profound effect on the symptoms of Tourette’s and a child’s future.

You can also watch her talk about specific treatments for Tourette’s and ADHD here, and her approach to OCD and Tourette’s here.

Now that we recognize that perhaps 80 percent of children who have a diagnosis of Tourette’s will have a comorbid, a co-occurring condition, we want to make sure that we’re screening for those conditions in the evaluation of any new patient who has Tourette’s. It’s established both in clinical settings and in the community that there’s a high co-occurrence or comorbidity. The most common conditions are attention-deficit hyperactivity disorder and obsessive-compulsive disorder. There are also others, including mood disorders, other kinds of anxiety disorders and learning disorders, a whole host of potential co-occurring conditions.

The reason it’s important to identify those early on is that they have a different developmental course or trajectory over time, and their presence definitely will impact the type of treatment that we’d be recommending for the child. So for example, if the child has attention-deficit hyperactivity disorder, you want to be thinking not only about what to do for the tics, but what will that treatment for the tics do for the ADHD or not, and vice versa? If we treat the ADHD, how will that impact the tics? And the same would be true for the other comorbid disorders.

It’s also important to understand, in the future course of the child with Tourette’s, that it’s quite likely that the tics are going to get better in early adolescence, right when puberty is beginning. But more often, the comorbid problems, particularly ADHD and OCD, are likely to continue. Very treatable, there’s a lot we can do, but it’s good to get a head start on that when we first see the child so you can anticipate what the needs are going to be in the future. For example, our basic treatments are behavioral treatment and medication, but we also work with the school, and thinking ahead to middle school, what are the needs going to be then to get in early, to get the intervention going and to be thinking about that when we’re starting treatment now?